Can an evidence-based fall prevention program be translated for use in culturally diverse communities?

Abstract

Older adult falls are a significant public health problem, but one that is amenable to preventive interventions. Despite the progress made in identifying risk factors, developing efficacious health-related interventions, and promoting evidencebased programs in the community, much work remains before these strategies are broadly available and effectively used to reduce fall-related injuries. As Newton and ScottFindlay have pointed out, the translation of basic scientific knowledge into clinical studies, and the transformation of clinical studies into improvements in health services and public health practices, remain major obstacles to widespread adoption. Donaldson and Finch have shown the feasibility of applying implementation science to sports injury prevention, and Li et al. demonstrated how an exercise and balance program (Tai Ji Quan) can successfully be translated into a community program and implemented in either community or clinical settings. Equally important was the fact that Li and his colleagues showed that program fidelity and adherence to their intervention was maintained, at least over the short term, to prevent older adult falls. Manson et al. showed positive results in taking a Tai Ji Quan program to low-income older adults, concluding that “non-(Tai Ji Quan) culturally related ethnic groups did not experience a barrier to participation in an older low-socioeconomic population sample”. However, the sample consisted of only 56 participants who were recruited into a 16-week program, and no attempt was made to translate the findings to the wider multi-ethnic community through the use of existing stakeholders. The article Implementing an evidence-based Tai Ji Quan program in a multicultural setting: A pilot dissemination project by Fink and Houston in this special issue of Journal of Sport and Health Science extends these findings and takes the next step. Specifically, the authors demonstrate that it is possible to scale up an effective health-related fall prevention program in a community of older adults with differing cultural backgrounds, provided that the intervention meets three criteria: